John B Dixon
General practitioners manage the majority of skin cancers in
Australia. There are a range of training opportunities for, and
certifications in, skin cancer management.
Between 15 June and 25 June 2008, an online examination was
placed on the Australasian College of Skin Cancer Medicine website.
Two hundred and forty-five college affiliated doctors were invited
by email to complete the examination. Thirty questions were asked
pertaining to the management of a hypothetical case study including
melanoma, basal cell carcinoma and squamous cell carcinoma.
Of 187 doctors who had an active responding email address, 140
(75%) took the examination. From a possible score of 100, the mean
score was 84 ± 16. The median score was 80.
Some trends emerged. Longer and more detailed training programs
correlated with better subsequent knowledge retention and safety.
Two days of training may not make doctors sufficiently safe in skin
cancer management; it appeared to improved knowledge, but not to a
point where unsafe practice was eliminated.
In Australia, the majority of skin cancers are managed by general practitioners.1 General practitioners are increasingly using advanced closure methods to repair defects following excision of skin cancers,1 and there have been mixed views expressed regarding whether GPs are suitably trained or skilled to diagnose and manage skin cancers.2–5 Heal et al's6 recent trial provides evidence that GPs in Townsville (Queensland) are competent at diagnosing skin cancer, comparable with specialist colleagues. Kelly at el7 demonstrated that both specialists and GPs frequently manage melanoma suboptimally, but did not address basal cell carcinoma (BCC ) and squamous cell carcinoma (SCC ) management.
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